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Dyspareunia
DSM-III In DSM-III, this disorder is called Functional Dyspareunia For more information, see Psychosexual Dysfunctions Diagnostic Criteria A'''. Coitus is associated with recurrent and persistent genital pain, in either the male or the female. '''B. The disturbance is not caused exclusively by a physical disorder, and is not due to lack of lubrication, Functional Vaginismus, or another mental disorder. DSM-IV For more information, see Sexual Dysfunctions Diagnostic Criteria A'''. Recurrent or persistent genital pain associated with sexual intercourse in either a male or a female. '''B. The disturbance causes marked distress or interpersonal difficulty. C'. The disturbance is not caused exclusively by Vaginismus or lack of lubrication, is not better accounted for by another mental disorder (except another Sexual Dysfunction), and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition. ''Specify type: * '''Lifelong Type * Acquired Type Specify type: * Generalized Type * Situational Type Specify: * Due to Psychological Factors * Due to Combined Factors Differential Diagnosis Sexual Dysfunction Due to a General Medical Condition Dyspareunia must be distinguished from Sexual Dysfunction Due to a General Medical Condition. The appropriate diagnosis would be Sexual Dysfunction Due to a General Medical Condition when the dysfunction is judged to be due exclusively to the physiological effects of a specified general medical condition (e.g., insufficient vaginal lubrication; pelvic pathology such as vaginal or urinary tract infections, vaginal scar tissue, endometriosis, or adhesions; postmenopausal vaginal atrophy; temporary estrogen deprivation during lactation; urinary tract irritation or infection; or gastrointestinal conditions). This determination is based on history, laboratory findings, or physical examination. If both Dyspareunia and a general medical condition are present but it is judged that the sexual dysfunction is not due exclusively to the direct physiological effects of the general medical condition, then a diagnosis of Dyspareunia, Due to Combined Factors, is made. Substance-Induced Sexual Dysfunction In contrast to Dyspareunia, a Substance-Induced Sexual Dysfunction is judged to be due exclusively to the direct physiological effects of a substance. Painful orgasm has been reported with fluphenazine, thioridazine, and amoxapine. If both Dyspareunia and substance use are present but it is judged that the sexual dysfunction is not due exclusively to the direct physiological effects of the substance use, then Dyspareunia, Due to Combined Factors, is diagnosed. If the sexual pain is judged to be due exclusively to the physiological effects of both a general medical condition and substance use, both Sexual Dysfunction Due to a General Medical Condition and Substance-Induced Sexual Dysfunction are diagnosed. Other mental disorders Dyspareunia is not diagnosed if it is caused exclusively by Vaginismus or a lack of lubrication. An additional diagnosis of Dyspareunia is usually not made if the sexual dysfunction is better accounted for by another mental disorder (e.g., Somatization Disorder). The additional diagnosis may be made when the orgasmic difficulty predates the mental disorder or is a focus of independent clinical attention. Dyspareunia can also occur in association with other Sexual Dysfunctions (except Vaginismus) and if criteria for both are met, both should be recorded. Occasional pain associated with sexual intercourse Occasional pain associated with sexual intercourse that is not persistent or recurrent or is not accompanied by marked distress or interpersonal difficulty is not considered to be Dyspareunia. DSM-5 See Genito-Pelvic Pain/Penetration Disorder